Deciding whether to attend a cardiac rehabilitation programme: an interpretative phenomenological analysis

Despite proven benefits of reducing mortality and morbidity (Dusseldorp et al. 1999; Linden et al. 1996), attendance at cardiac rehabilitation (CR) is low (King & Teo 1998). The aim of this research was to explore beliefs held on recovery and CR by attenders and non-attenders; and to examine the usefulness of the Self Regulatory Model and the Theory of Planned Behaviour when interpreting the results. Semi-structured interviews were carried out with a total of 21 people, 3 months after they had been admitted to a district hospital with myocardial infarction (MI). Nine people had attended a CR programme, six people had originally accepted an offer to attend, but then did not attend, and six people who declined the offer and did not attend. The transcripts were subjected to interpretative phenomenological analysis (IPA). Several key differentiating themes were identified: use of medical versus psychological model; illness perception; control; causal attribution; coping strategies; and attitude to CR. Attenders were more likely to see themselves in control of their recovery and to view the programme as a way of taking responsibility for improving their health and reducing their chances of recurrence. Attenders were also more likely to use information seeking ways of coping whilst non-attenders used avoidance/minimizing coping strategies. The technique of IPA proved useful in allowing an abstraction of the factors affecting the decision-making process.